Head of WHO returns despite Western opposition

 作者:冉虢匈     |      日期:2019-03-02 03:07:00
By PHYLLIDA BROWN and TARA PATEL The Who’s Japanese director-general, Hiroshi Nakajima, has been re-elected for a second term after a bitterly fought campaign that rocked the organisation. The result was announced last week in Geneva after a secret ballot of the WHO’s executive board. Nakajima, whose candidacy was opposed by the US and the European Community, will lead the organisation for another five years. In theory, the executive board’s choice must still be approved by the World Health Assembly in May but this is usually a formality. Nakajima’s main rival for the job was Mohammed Abdelmoumene, an Algerian neuroscientist who was formerly his deputy in Geneva. The US and the European Community voted for Abdelmoumene because they believed Nakajima’s management style was damaging the credibility of the WHO and the morale of its staff at a time when challenges such as tackling AIDS and malaria demand inspired leadership. Nakajima’s supporters, meanwhile, point out that during his first term of office, Japan’s donations to the WHO grew until the country became the organisation’s second biggest donor after the US. The executive board, which consists of individuals nominated by 31 representative member states of the WHO, voted 18 to 13 in favour of Nakajima. His supporters were almost entirely from Latin America and Africa. Before the election, critics inside and outside the WHO voiced fears that, if Nakajima were re-elected, the WHO might lose the funding and commitment of major donor nations, in a crisis comparable to that which engulfed UNESCO in the mid-1980s. Complaints were also rife about the election campaign. Small developing countries on the executive board were widely alleged to have been pressured by Japan with offers of aid and threats of loss of trade – allegations that Japan has hotly denied (This Week, 19 December). It is not yet clear how the result will affect the relationship between the WHO and its Western donors, although most are at pains to stress publicly their loyalty to the organisation itself. Morris Abram, the US’s representative to the UN in Geneva, said last week: ‘Such is our dedication to the work and the necessity of WHO that we will of course support the agency regardless of any personalities. We think the agency is of tremendous importance to the world and we think it is vital that it be efficient and well managed, and we will work very hard towards that end, whoever is in office.’ British officials issued a statement congratulating Nakajima. ‘Throughout the election process the interests of the organisation have been the UK’s sole concern . . . We trust that during his second term Dr Nakajima will work alongside all member states in making the best use of the organisation’s resources to tackle the enormous challenges it faces.’ Jonathan Mann, professor of international health at Harvard University and the former director of the WHO’s Global Programme on AIDS, criticised the electoral system at the WHO. There is no formal advertising of the post, no public debate and no formal discussion of policy issues. ‘Thirty-one people have made what is probably the most important decision in global health with no public scrutiny,’ he said. The system should be reformed to make it more open. Mann resigned from the WHO in 1990 after a clash with Nakajima. The executive board’s meeting continued throughout this week. As New Scientist went to press, member states were struggling to reach consensus on the WHO’s projected budget for 1994/95, but the outlook appeared bleak. Headquarters in Geneva has asked donors for large increases. US officials say they are being asked to provide an increase of as much as 22 per cent, which they say is unrealistic. However, if the donors fail to reach agreement on the budget the US is automatically obliged under a Congressional requirement to withhold one-fifth of its existing contribution. Washington wants to avoid this and officials are trying to reach a compromise. ‘These are difficult economic times worldwide, and we want to work with other member states and the agency to get a realistic budget that is going to be accepted by Congress,’ says Harold Thompson, health attache at the US mission to the UN in Geneva. He stressed that the haggling over the budget had begun months ago and was not related to Nakajima’s re – election, although he conceded that it might be perceived or portrayed by others as being so. The same headache would have faced Abdelmoumene had he been elected,